Tei指数评价增强型体外反搏对冠心病患者心功能的影响  

Effects of enhanced external counterpulsation on heart function in patients with coronary heart disease by the Tei-index

作　　者：胡丹[1] 方平[1] 谭跃萍[1] 王磊[1] 丛阳[1] 

机构地区：[1]第二军医大学附属长征医院贵宾诊疗科,上海200003

出　　处：《中国医学影像技术》2008年第2期228-230,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的与传统评价左室舒张功能的指标比较,探讨Tei指数评价增强型体外反搏(EECP)治疗冠心病患者心功能变化的临床应用价值。方法46例冠心病患者接受EECP治疗,分别于第一次反搏前、第一次反搏后即刻、第二次反搏前、治疗一周后及治疗二周后行超声心动图检查,测量左心室Tei指数、二尖瓣血流频谱舒张早期和晚期血流峰值速度之比(E/A)、等容舒张时间(IVRT)、肺静脉血流频谱收缩波和舒张波峰值速度之比(S/D)及反向波峰值速度(ARW)。结果第一次反搏后即刻较第一次反搏前比较E/A、S/D明显增大,ARW明显减小,差异均有统计学意义(P<0.01),第二次反搏前、治疗一周后、两周后较第一次反搏前比较E/A、S/D逐渐增大,仅治疗两周后与第一次反搏前比较差异有统计学意义(P<0.01),而ARW逐渐减小,各组间比较差异均有统计学意义(P<0.01～0.05),IVRT变化与ARW相同,但各组间比较均无统计学意义(P>0.05),反搏治疗后Tei指数逐渐减低,除第一次反搏后即刻与第一次反搏前比较差异无统计学意义外,其余各组间比较差异均有统计学意义(P<0.01)。结论增强型体外反搏可改善冠心病患者的心功能,Tei指数可简便、敏感地评价心脏整体功能,且不受心脏前后负荷的影响。Objective To study the clinical value of Tei-index for evaluation the heart function of patients with coronary heart disease （CHD） treated by enhanced external counterpulsation （EECP） compared traditional diastolic heart function index .Methods Forty six patients with CHD were treated with one course of EECP, left ventricular Tei-index, E/A ratio at mitrial orifice （E/A）, isovolumic relaxation time （IVRT）, ratio of systolic wave to diastolic wave of pulmonary vein flow （S/D） and atrial reversal wave （ARW） were respectively measured by Doppler echocardiography before EECP, the first time of EECP instantly, before the second time of EECP, one week later and two weeks later. Results The E/A, S/D ratio obviously increased, while ARW obviously deseased in the first time of EECP instantly compared with before EECP （P〈0.01）. Then E/A, S/D ratio gradually increased at the last three times measurements compared with before EECP, there has significant differences only between before EECP and two weeks later （P〈0.01）. At the same time ARW gradually deseased and there has significant differences between two groups （P〈0.01-0.05）. The change of IVRT is same as ARW, but there has no significant differences betweens two groups （P〉0.05）. Tei-index gradually deseased after therapy, there has significant differences between two groups （P〈0.01） except between before EECP and the first time of EECP instantly （P〉0.05）. Conclusion It is demonstrated that EECP can effectively improved the heart function in patients with CHD, the Tei-index is a simple and sensitive parameter for evaluation heart allomeric function, and it isn＇t effected by the preload and afterload of heart.

关 键 词：TEI指数 反搏动术 冠状动脉疾病 心脏功能试验 

分 类 号：R541.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]